title: Which factors are associated with trainees' confidence in performing obstetric and gynecological ultrasound examinations?
abstract: OBJECTIVE
  To explore the association between clinical training characteristics and trainees' level of confidence in performing ultrasound scans independently.
  
  
  METHODS
  A cross-sectional e-survey was distributed to members of the national societies of junior obstetricians/gynecologists in Denmark, Sweden and Norway (n = 973). Multiple linear regression models were used to explore the effect that amount of time spent in specialized ultrasound units and clinical experience had on trainees' confidence in performing ultrasonography independently. Exploratory factor analysis was used to identify factors that contributed to trainees' confidence in performing ultrasonography. Trainees' ultrasound confidence was finally compared with their expected levels of performance.
  
  
  RESULTS
  Of the 682 respondents (response rate 70.1%), 621 met the inclusion criteria. Clinical experience and time spent in specialized ultrasound units were predictors of trainees' confidence in performing ultrasonography independently (P < 0.001). Trainees required more than 24 months of clinical experience and 12-24 days of training in specialized ultrasound units in order to feel confident about performing transvaginal and transabdominal ultrasound scans independently. Three factors were related to ultrasound confidence: technical aspects, image perception and integration of scan into patient care. There were significant differences between trainees' level of confidence and their expected levels of performance (P < 0.001).
  
  
  CONCLUSIONS
  Clinical experience and time spent in specialized ultrasound units were predictors of trainees' confidence in performing ultrasonography independently. Discrepancies between trainees' confidence and their expected levels of performance raised concerns about the adequacy of current ultrasound training programs.
authors.affiliation: Department of Obstetrics, Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: M G
authors.initials: MG
authors.lastname: Tolsgaard
authors.forename: M B
authors.initials: MB
authors.lastname: Rasmussen
authors.forename: C
authors.initials: C
authors.lastname: Tappert
authors.forename: M
authors.initials: M
authors.lastname: Sundler
authors.forename: J L
authors.initials: JL
authors.lastname: Sorensen
authors.forename: B
authors.initials: B
authors.lastname: Ottesen
authors.forename: C
authors.initials: C
authors.lastname: Ringsted
authors.forename: A
authors.initials: A
authors.lastname: Tabor
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003430:Cross-Sectional Studies; D003718:Denmark; D004502:Education, Medical, Continuing; D004503:Education, Medical, Graduate; D005260:Female; D006176:Gynecology / Q000193:education / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D009774:Obstetrics / Q000193:education / Q000592:standards; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013548:Sweden; D014465:Ultrasonics / Q000193:education / Q000592:standards
keywords: learning curves; medical education; ultrasound assessment; ultrasound competence; ultrasound training